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J Knee Surg
DOI: 10.1055/a-2281-1736
Original Article

Two-Year Functional Outcomes of Nonsurgical Treatment in Concomitant Anterior Cruciate Ligament and Medial Collateral Ligament Injuries: A Case-Control Study

Heleh Dadgostar
1   Department of Sports and Exercise Medicine, School of Medicine, Hazrat e Rasool General Hospital, Iran University of Medical Sciences, Tehran, Iran
,
Mojgan Zarrini
1   Department of Sports and Exercise Medicine, School of Medicine, Hazrat e Rasool General Hospital, Iran University of Medical Sciences, Tehran, Iran
,
Amir Human Hoveidaei 
2   Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
,
Reza Sattarpour
3   School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
,
Saeed Razi
4   Bone and Joint Reconstruction Research Center, Department of Orthopedics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
,
Peyman Arasteh
5   Shiraz University of Medical Sciences, Shiraz, Iran
,
Mohammad Razi
6   Department of Orthopedic Surgery, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
› Author Affiliations Funding This study was granted by the Iran University of Medical Sciences (Grant Number: 15108)
› Further Information
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Abstract

The anterior cruciate ligament (ACL) is a common knee injury in high-intensity sports, which can cause early career loss in young athletes. Concomitant damage to other knee stabilizers may occur, such as the medial collateral ligament (MCL). Recent studies have shown that knee stability can increase without surgical intervention in patients with ACL and MCL injuries. Regarding the importance of functional tests in return to exercise prediction, this study aims to measure nonsurgical approach's long-term outcome for concomitant ACL and MCL injuries with a focus on functional tests. This is a case-control study with a 2-year follow-up. The case group consisted of patients who had provided written consent and completed their 2-year follow-up, and the control group was made up of healthy people who did not have any knee medical conditions and were matched by age, gender, and activity level. Physical examinations, Tegner and International Knee Documentation Committee questionnaires, and knee magnetic resonance imaging were conducted, and functional performance tests were performed after a 10-minute warm-up. Lody's index (the ratio of injured-to-uninjured knee results) was calculated. The data were analyzed using independent t-test, one-way analysis of variance, chi-squared test, and Fisher's exact test. The study involved 11 patients in each concomitant ACL and MCL injury cases and healthy control groups with a mean age of 32.4 and 28 years, respectively. None of the patients reported knee instability symptoms in the 2-year follow-up. More than half of the patients continued their sports field without reinjury, with no significant difference in activity levels between case and control groups. The 6-meter hop test and single-leg hop test showed no significant difference between case and control groups (p-value: 0.326, 0.859), and no significant difference was observed in the three Carioca, cocontraction, and Shuttle tests in the 2-year follow-up. Functional tests in ACL and MCL injuries revealed normal outcomes, implying a nonsurgical approach for patients with proximal ACL tears, better knee stability, and no significant differences between the injured and control groups.

Keywords

anterior cruciate ligament - nonsurgical treatment - medial collateral ligament - functional outcome


Publication History

Received: 15 June 2023

Accepted: 01 March 2024

Accepted Manuscript online:
05 March 2024

Article published online:
06 May 2024

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